Tetanus is a bacteria infection that is caused by a bacteria called clostridium tetani which produces a toxin that cause painful muscle contractions. it is sometimes called "lockjaw" as it cause the neck and jaw muscles to lock making it difficult to swallow and open mouth.

The clostridium tetani bacteria is usually found in the soil, dust and manure and can survive for long time outside the body. It enters the body through a cut, bites or wound. Once the bacteria enters the body, it multiplies rapidly and produce a toxin that invades the nerves resulting in muscle spasm and stiffness. It does not spread from person to person.

Symptoms start within 4-21 days post exposure. Early symptoms include high fever, lockjaw , difficulty swallowing , stiffness in neck and abdomen muscles.Later symptoms include severe muscle spasms, generalized tonic seizure-like activity, severe autonomic nervous system disorders. if left untreated, death may result.

Treatment of tetanus is proper cleansing and debridement of any foreign body and dead tissue. Give a shot of tetanus immunoglobulin which contains antibodies that kill the tetanus bacteria. Patient must be admitted into ICU and put into ventilator as the muscle spasm will result in suffocation. Muscle relaxants and sedatives are given to relax the muscles.

Prevention with tetanus vaccination is available.

Tetanus vaccination

Tetanus vaccination is part of the childhood vaccination programme. Tetanus is usually given together as a combination vaccine with diphtheria, pertussis (whooping cough) as a DTaP. It can also be given with other vaccines as a combo 5-in-1 or 6-in-1 vaccine.

Childhood vaccination requires five DTaP shots with a regime at ages as below:

2 months

4 months

6 months

15 through 18 months

4 through 6 years of age

Td is a vaccine protecting against diphtheria and tetanus. It is given to pre-teens, teenagers and adults as a booster every ten years or post exposure. As the immunity decreases with time hence the booster is given at ten years interval.

Tdap is a vaccine protecting against diphtheria, pertussis and tetanus. It can be given as a one time booster instead of Td too. It is important for those who are in close contact with infants.

For travellers going to places where there is limited medical facilities and if the last dose of tetanus jab is more than ten years ago, a booster jab is recommended before travel.

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